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J Pain. 2016 Jun;17(6):685-93. doi: 10.1016/j.jpain.2016.01.477. Epub 2016 Feb 26.

Overlap and Differences Between Patient and Provider Expectations for Treatment Outcomes: The Case of Acupuncture.

Author information

1
Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland. Electronic address: mail@juergen-barth.de.
2
Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
3
Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité- Universitätsmedizin Berlin, Berlin, Germany.

Abstract

Our study aimed to identify patient-provider clusters with different patterns of expectations for treatment outcomes. All patients (n = 885) received acupuncture treatment from physicians for their migraine, headache, osteoarthritis, or chronic low back pain. We identified 6 robust patient-provider expectation clusters (PPECs; interclassification reliability >.89) showing differences between patients and providers in their expected treatment responses (eg, unrealistic optimists, optimistic doubters). For example, the optimistic doubters had high expectations for their treatment outcomes but were skeptical of the benefits of acupuncture in general. The providers expected good improvements for these patients. These 6 PPECs differed in their clinical characteristics and in the associated treatment responses. For example, unrealistic optimists showed the weakest treatment benefits after 6 months; other PPECs and clinical patterns are also presented in the report. Our study suggests that comparing the expectations of patients and providers is a valuable approach to identify groups of patients with greater responsiveness and those with limited treatment benefits.

PERSPECTIVE:

Patients and providers of acupuncture might vary in their expectation of the treatment effect and in clinical practice the overlap of expectations of patients and providers should be considered as important in initial consultations.

KEYWORDS:

Expectation; acupuncture; cluster analysis; pain; prospective study

PMID:
26921463
DOI:
10.1016/j.jpain.2016.01.477
[Indexed for MEDLINE]

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